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Dividend Replacement Request
This form is to be used when a shareholder dividend or special distribution has been lost or destroyed. Replacement checks can be
requested ten business days after the
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How to fill out dividend replacement request

How to fill out dividend replacement request
01
To fill out a dividend replacement request, follow these steps:
02
Contact the company or organization that issued the dividend and request a replacement form.
03
Fill out the replacement form with your personal details, such as your name, address, and contact information.
04
Provide the necessary information about the dividend, including the dividend payment date, the amount of the dividend, and any relevant reference numbers.
05
Attach any supporting documents as required, such as proof of ownership or proof of loss.
06
Double-check all the information provided on the form to ensure accuracy.
07
Submit the completed form and any supporting documents to the company or organization through the designated channel, such as mail or online submission.
08
Keep a copy of the completed form and any related correspondence for your records.
09
Follow up with the company or organization to confirm receipt of your request and to inquire about the status of your dividend replacement.
Who needs dividend replacement request?
01
Anyone who has received a dividend payment and has lost the original dividend check, misplaced it, or never received it in the first place may need to submit a dividend replacement request.
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What is dividend replacement request?
A dividend replacement request is a form submitted to request a replacement for a lost or stolen dividend check.
Who is required to file dividend replacement request?
Any shareholder who has lost or misplaced their dividend check is required to file a dividend replacement request.
How to fill out dividend replacement request?
To fill out a dividend replacement request, shareholders must provide their personal information, details of the lost check, and any relevant supporting documents.
What is the purpose of dividend replacement request?
The purpose of a dividend replacement request is to ensure that shareholders receive the dividends owed to them, even if their original check is lost or stolen.
What information must be reported on dividend replacement request?
Information such as the shareholder's name, address, account number, details of the lost check, and any relevant supporting documents must be reported on a dividend replacement request.
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